HSA 305 Midterm Exam Questions With
Answers 100% Correct
Reimbursement - ANSWER The healthcare term for referring to compensatiom or
repayment for healthcare services
Before - ANSWER In healthcare, services are usually provided before or after a payment
is made?
Party - ANSWER An entity that receives, renders, or pays for health services
First party - ANSWER The patient himself or herself, or person that is responsible for the
patient's health bill
Second party/providers - ANSWER The physician, clinic, hospital, nursing home or other
healthcare entity rendering the care
Third party - ANSWER The payer, an uninvolved insurance company or health antenatal
that pays the physician, clinic, or other second-party provider for the care or services
rendered to the first party(patient)
Fee for service reimbursement - ANSWER A healthcare payment method in which
providers receive payment for each service rendered
, Fee - ANSWER A set amount/price
Charges - ANSWER
Claim - ANSWER Request for payment, or itemized statement of healthcare services and
their costs, provided by a hospital, physician's office, or other healthcare provider.
Submitted for reimbursement to third-party payer.
Deductible - ANSWER Annual amount of money that policyholder must incur (and pay)
before the health insurance will assume liability for the remaining charges or covered
expenses.
Copayment - ANSWER Cost-sharing measure in which policy or certificate holder pays a
fixed dollar amount (flat fee) per service, supply, or procedure that is owed to the
healthcare facility by the patient; may vary by type of service, such as $20.00 per
prescription or $30.00 per physician office visit
Self pay
Traditional retrospective payment
Managed care - ANSWER The three types of fee for service reimbursements
Self pay - ANSWER Patients/guarantors pay a specific amount for each service received
Answers 100% Correct
Reimbursement - ANSWER The healthcare term for referring to compensatiom or
repayment for healthcare services
Before - ANSWER In healthcare, services are usually provided before or after a payment
is made?
Party - ANSWER An entity that receives, renders, or pays for health services
First party - ANSWER The patient himself or herself, or person that is responsible for the
patient's health bill
Second party/providers - ANSWER The physician, clinic, hospital, nursing home or other
healthcare entity rendering the care
Third party - ANSWER The payer, an uninvolved insurance company or health antenatal
that pays the physician, clinic, or other second-party provider for the care or services
rendered to the first party(patient)
Fee for service reimbursement - ANSWER A healthcare payment method in which
providers receive payment for each service rendered
, Fee - ANSWER A set amount/price
Charges - ANSWER
Claim - ANSWER Request for payment, or itemized statement of healthcare services and
their costs, provided by a hospital, physician's office, or other healthcare provider.
Submitted for reimbursement to third-party payer.
Deductible - ANSWER Annual amount of money that policyholder must incur (and pay)
before the health insurance will assume liability for the remaining charges or covered
expenses.
Copayment - ANSWER Cost-sharing measure in which policy or certificate holder pays a
fixed dollar amount (flat fee) per service, supply, or procedure that is owed to the
healthcare facility by the patient; may vary by type of service, such as $20.00 per
prescription or $30.00 per physician office visit
Self pay
Traditional retrospective payment
Managed care - ANSWER The three types of fee for service reimbursements
Self pay - ANSWER Patients/guarantors pay a specific amount for each service received
